<p>A 63‑year‑old man with essential hypertension presented with prolonged high‑grade fever, night sweats, weight loss, and anorexia. Laboratory evaluation revealed thrombocytopenia, elevated inflammatory markers, mildly raised transaminases, and increased LDH, while extensive workup for bacterial and viral causes was unrevealing. Bone marrow aspirate performed for pyrexia of unknown origin demonstrated numerous intracellular and extracellular yeast forms consistent with Histoplasma capsulatum, showing narrow‑based budding and a surrounding halo artifact. Based on these characteristic cytomorphological findings, empirical antifungal therapy with liposomal amphotericin B was initiated, leading to marked clinical improvement. Disseminated histoplasmosis is a potentially fatal opportunistic infection, classically associated with immunocompromised states, yet up to 15% of cases occur in immunocompetent individuals. Bone marrow involvement often manifests with cytopenias and provides a rapid diagnostic clue in endemic regions. This case highlights the critical role of bone marrow examination in diagnosing disseminated histoplasmosis and emphasizes its consideration in patients with prolonged fever and cytopenias, even without traditional risk factors.</p>